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SHORT COMMUNICATION
Year : 2011  |  Volume : 55  |  Issue : 2  |  Page : 125-127  

Unintentional injuries among children admitted in a tertiary care hospital in North Kerala


1 Professor, Pediatric Surgery, Govt. Medical College, Calicut, Kerala, India
2 Assistant Professor, Community Medicine, Govt. Medical College, Calicut, Kerala, India
3 Senior Lecturer, Community Medicine, Govt. Medical College, Calicut, Kerala, India
4 Resident, Pediatric Surgery, Govt. Medical College, Calicut, Kerala, India

Date of Web Publication22-Sep-2011

Correspondence Address:
Asma Rahim
Assistant Professor, Department of Community Medicine, Govt. Medical College, Calicut, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-557X.85248

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   Abstract 

World Health Organization global disease update (2004) points out injuries as the sixth leading cause of morbidity and mortality in childhood. A descriptive hospital based study was conducted to find out the common types of unintentional injuries among children admitted for management of unintentional injuries in Pediatric Surgery department and Intensive Care Unit of a tertiary care hospital of North Kerala and to find out the contributing risk factors. A total of 400 children admitted during the study period of 6 months of 2009 constituted the study population. Mechanical injuries comprising of Road traffic accidents and accidental fall were the major cause of unintentional injuries (36%), followed by Poisoning (22.3%). A higher proportion of unintentional injuries were noted to occur among children of younger mothers, overactive child, children belonging to extended or joint families, child left alone or with friends, pre-school children, male child and from urban dwellings. The study highlights the need to identify the different types of unintentional injuries and the risk factors of childhood injuries which require hospitalisation. Identification of risk factors will help to formulate strategies aimed at risk reduction and prevention of childhood injuries.

Keywords: Children, Tertiary hospital, Unintentional injuries


How to cite this article:
Sheriff A, Rahim A, Lailabi M P, Gopi J. Unintentional injuries among children admitted in a tertiary care hospital in North Kerala. Indian J Public Health 2011;55:125-7

How to cite this URL:
Sheriff A, Rahim A, Lailabi M P, Gopi J. Unintentional injuries among children admitted in a tertiary care hospital in North Kerala. Indian J Public Health [serial online] 2011 [cited 2019 May 26];55:125-7. Available from: http://www.ijph.in/text.asp?2011/55/2/125/85248

Unintentional Injury is defined as damage caused to a person due to an acute transfer of Energy (Mechanical, Chemical, Thermal, Electrical, and radiation) for which there is no predetermined intent. [1] Unintentional injury is one of the most important causes of death during childhood and adolescence beyond the first few months of life and also represents one of the most important causes of preventable pediatric morbidity and mortality.

Unintentional accidental injuries are the commonest cause of hospital admission and death and can result in lifelong disability. They are a threat to health in every country, are currently responsible for about 7% of world mortality, and this proportion is predicted to rise. World Health Organization report 2004 points out injuries as the sixth leading cause of Morbidity and Mortality in childhood. [2] With this background a study was conducted to study the profile of unintentional injuries among children admitted in a busy tertiary care hospital and to find out factors related to the unintentional injuries among these children.

This study was conducted in the Maternal and Child Health wing of Government Medical College, Calicut. Pediatric surgery and pediatric ICU of the institute caters to approximately 2000 Pediatric (upto the age of 12 years) injury visits annually per year. The childhood trauma profile of 400 children admitted in the pediatric surgery ward and ICU for management of unintentional injuries over a six month from June 2009 to November 2009 were collected and analysed by the investigators. Informed consents were sought from the parents, guardians or rarely from the bystanders. A pre-structured and pre-tested questionnaire was administered to assess the common types of unintentional injury and related factors like age and sex of the child, age of the mother, activity of the child, rural-urban dwelling, socioeconomic status, type of family, attention given to child at the time of incident etc. The information was collected from parents, older children, informant or bystander. Data were entered in Microsoft excel spread sheet and analysis done using SPSS statistical software package.

Four hundred children with a mean age of 5.2 years (5.2 years +/41 months) were enrolled during the study period. Among them male children were more as compared to Female (1.8:1). Poisoning 89 (22.3%) was the most common cause of unintentional injury, followed by Road Traffic Accidents (RTA) 76 (19%) and fall 68 (17%) as noted in [Table 1].
Table1: Reasons for admission of children with unintentional injuries and types (as per ICD-10 Classifi cation)

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Seventy percent of the subjects were from rural area. Of the 400 subjects 43% had one sibling and 35% had two siblings. 40.5% of the subjects were first and 35.5% were second order birth children. 43(10.7%) subjects had past history of one unintentional injury. 28 /43(64%) of the past unintentional injuries were due to fall. 324 (81%) of the children were overactive based on the verbal account of the informant. 224(56%) were from extended families. 228(57%) of home were having thatched roof and the flooring was cement in 55% cases. Electricity was not available in 60(15%) houses. 81% of the families were having wells as the source of drinking water. Majority (56.2%) of houses were using fire wood as the means of cooking. Out of the 400 families 204(51%) were storing kerosene at home.

Out of the 274 injuries with involvement of different body regions (excluding poisoning, suffocation, and foreign bodies), head region was most commonly involved in 135 (49%) followed by lower limb in 125 (45%) with neck region the least affected 19(6.7%). 46 children each were afflicted with injuries in Upper limb and abdomen.

On analyzing the different types of injuries the mean age of the children admitted due to RTA was 85 months. Of the 76 subjects who met with RTA majority 39(52.2%) were pedestrians and injury occurred while crossing the road.32 (83.3%) of the burn/scald cases occurred at their own home setting, Out of the 70 cases of fall 47.6% was from wall. Out of the 34 cases of unintentional injury due to foreign body 50% was due to coin ingestion and 50% due to organic matters. Of the 34 cases the site of localization was 14 (40%) in the trachea and 20 (60%) in esophagus.

This study once again highlighted that the 1-5 year age group to be the most susceptible to injuries as noted in similar studies. [3] Age-specific rates showed peak incidence of pedestrian injuries among 6-10 year old children, of bicyclist injuries among 9-15 year old children, and of motor vehicle occupant injuries among adolescents between the ages of 12 and 16 years as noted in other studies. [4],[5]

As depicted in [Table 1] Poisoning 89(22.3%) was the major cause of unintentional injury followed by RTA 76 (19%) and fall 70(17.4 %). 57.9% of the injuries occurred at home. The leading type of poison was drugs (48.1%) followed by household products (22.2%). A significant association was obtained between Poison within the reach of child and age group similar to the one noted in a study done by Fariba et al. [6]

Childhood unintentional injuries are not simply accidents but events that in many cases can be prevented with a better understanding of their cause and appropriate interventional strategies. Leaving the child alone or with peers have contributed to the occurrence of injuries. Sensitizing the mothers and caretakers on precautions while rearing children is the need of the hour. Injury prevention programs are most likely to be effective in reducing the frequency of injuries if they reach those children who experience the most injuries.

 
   References Top

1.Child and adolescent injury prevention: A Global Call for Action, World Health Organization Publication: Mar 2005. p. 3-5.  Back to cited text no. 1
    
2.Global burden of disease 2004. Update World Health Organization, 2008. p. 8-22.   Back to cited text no. 2
    
3.Ahmed A, Arif A, Patti J, Tyrone F, Syed M. The Epidemiology of Unintentional Non-fatal Injuries Among Children in the South Plains/Panhandle Region of Texas. Texas J Rural Health 2003;21:(2):31-41.  Back to cited text no. 3
    
4.Adesunkanmi RK, Oginnil M, Oyelamio A, Badru OS. Road traffic accidents to African children. International Journal of the KR of the injured. 2000;31:279-99.   Back to cited text no. 4
    
5.Pless IB, Verreault R, Tenina S. A case-control study of pedestrian and bicyclist injuries in childhood. Am J Public Health 1989;79:995-8.  Back to cited text no. 5
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6.Fariba F, Seyed S, Seyed M, Hojatollah J. A study of 1120 poisoned patients younger than 12 years at Loghman Hakeem Poison Control Center, Tehran, Iran, 2000-2001 Internet J Pediatrics Neonatol ISSN: 2002;2:1528-30.  Back to cited text no. 6
    



 
 
    Tables

  [Table 1]


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